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糖尿病母亲所生婴儿的心血管畸形:一项回顾性病例对照研究。

Cardiovascular Malformations in Infants of Diabetic Mothers: A Retrospective Case-Control Study.

作者信息

Akbariasbagh Parvin, Shariat Mamak, Akbariasbagh Naseredin, Ebrahim Bita

机构信息

Department of Cardiology, Maternal/Fetal and Neonatal Research Center, Family Health Institute, Tehran University of Medical Sciences, Tehran, Iran.

Maternal/Fetal and Neonatal Research Center, Family Health Institute, Tehran University of Medical Sciences, Tehran, Iran.

出版信息

Acta Med Iran. 2017 Feb;55(2):103-108.

Abstract

Maternal diabetes has teratogenic effects on the evolution of the fetal cardiovascular system; as a consequence, cardiovascular malformations are the most common anomalies in infants of diabetic mothers. The present study focuses on the association of all types of diabetes in mothers with the incidence of congenital cardiovascular malformations in their infants. In this retrospective case-control study performed between the years 2008 and 2010, 35 infants of diabetic mothers were selected as a case group, and another 35 infants of mothers with normal blood glucose levels were selected as a control group. Data has been extracted from patients' files and registered. Finally, the association of data has been performed according to statistical analysis. According to the results, the prevalence of cardiovascular anomalies was significantly higher in infants of diabetic mothers (P=0.018). The most common malformations in the case group were PDA 10%, hypertrophic cardiomyopathy 9% and PFO 8%. Maternal diabetes type (overt or gestational diabetes), duration and control method did not correspond with any significant differences in the prevalence of cardiac anomalies. The results of this study indicate that diabetes in pregnant women plays an important role in the incidence of certain types of cardiac anomalies, such as PFO, HCMPT, and PDA. As a result, the performance of diagnostic procedures (like embryonic echo, before and after birth), provision of special prenatal care to diabetic mothers, and providing supportive and therapeutic care to symptomatic infants seems highly advisable in such cases.

摘要

母体糖尿病对胎儿心血管系统的发育具有致畸作用;因此,心血管畸形是糖尿病母亲所生婴儿中最常见的异常情况。本研究聚焦于母亲患各类糖尿病与她们所生婴儿先天性心血管畸形发生率之间的关联。在这项于2008年至2010年开展的回顾性病例对照研究中,选取35名糖尿病母亲所生婴儿作为病例组,另选35名血糖水平正常的母亲所生婴儿作为对照组。已从患者档案中提取数据并进行登记。最后,根据统计分析对数据进行了关联分析。结果显示,糖尿病母亲所生婴儿心血管异常的患病率显著更高(P = 0.018)。病例组中最常见的畸形为动脉导管未闭(PDA)占10%、肥厚型心肌病占9%以及卵圆孔未闭(PFO)占8%。母亲糖尿病类型(显性或妊娠期糖尿病)、病程及控制方法与心脏异常患病率的任何显著差异均无关联。本研究结果表明,孕妇糖尿病在某些类型心脏异常(如卵圆孔未闭、肥厚型心肌病、动脉导管未闭)的发生率中起重要作用。因此,在此类情况下,进行诊断程序(如出生前后的胚胎超声检查)、为糖尿病母亲提供特殊产前护理以及为有症状的婴儿提供支持性和治疗性护理似乎非常可取。

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